Incidental findings on brain MRI in the general population
Incidental findings on brain MRI in the general population
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DOI：
10.1056/nejmoa070972
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发表时间：
2007-11-01
影响因子：
158.5
通讯作者：
van der Lugt, Aad
中科院分区：
文献类型：
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作者：
Vernooij, Meike W.;Ikram, M. Arfan;van der Lugt, Aad
背景资料：大脑的磁共振成像（MRI）越来越多地用于研究和临床医学，扫描仪硬件和MRI序列也在不断改进。这些进展可能导致检测到意外的、无症状的脑异常，如脑肿瘤、动脉瘤和亚临床血管病理变化。我们进行了一项研究，以确定这种偶然的大脑发现在一般population.Methods的患病率：受试者为2000人（平均年龄，63.3岁，范围，45.7至96.7），从人口为基础的鹿特丹研究中，高分辨率，结构性脑MRI（1.5 T）进行了根据标准化的协议。两名经过培训的审查员记录了所有脑部异常，包括无症状脑梗死。使用自动后处理技术定量白质病变的体积（单位：毫升）。两名经验丰富的神经放射科医生审查了所有偶然发现。所有的诊断都是基于MRI的结果，和额外的组织学确认没有获得。结果：无症状的脑梗死存在于145人（7.2%）。在脑梗死以外的其他发现中，脑动脉瘤（1.8%）和良性原发性肿瘤（1.6%），主要是脑膜瘤，是最常见的。无症状的脑梗死和脑膜瘤的患病率随着年龄的增长而增加，白质病变的体积，而动脉瘤显示没有年龄相关的患病率增加。结论：偶然的大脑MRI结果，包括亚临床血管病理变化，是常见的在一般人群。最常见的是脑梗塞，其次是脑动脉瘤和良性原发性肿瘤。需要了解这些病变的自然病程信息，以指导临床管理。
Background: Magnetic resonance imaging (MRI) of the brain is increasingly used both in research and in clinical medicine, and scanner hardware and MRI sequences are continually being improved. These advances are likely to result in the detection of unexpected, asymptomatic brain abnormalities, such as brain tumors, aneurysms, and subclinical vascular pathologic changes. We conducted a study to determine the prevalence of such incidental brain findings in the general population.Methods: The subjects were 2000 persons (mean age, 63.3 years; range, 45.7 to 96.7) from the population-based Rotterdam Study in whom high-resolution, structural brain MRI (1.5 T) was performed according to a standardized protocol. Two trained reviewers recorded all brain abnormalities, including asymptomatic brain infarcts. The volume of white-matter lesions was quantified in milliliters with the use of automated postprocessing techniques. Two experienced neuroradiologists reviewed all incidental findings. All diagnoses were based on MRI findings, and additional histologic confirmation was not obtained.Results: Asymptomatic brain infarcts were present in 145 persons (7.2%). Among findings other than infarcts, cerebral aneurysms (1.8%) and benign primary tumors (1.6%), mainly meningiomas, were the most frequent. The prevalence of asymptomatic brain infarcts and meningiomas increased with age, as did the volume of white-matter lesions, whereas aneurysms showed no age-related increase in prevalence.Conclusions: Incidental brain findings on MRI, including subclinical vascular pathologic changes, are common in the general population. The most frequent are brain infarcts, followed by cerebral aneurysms and benign primary tumors. Information on the natural course of these lesions is needed to inform clinical management.